Organization
SAMUEL D. GARRETT OD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL DAVID GARRETT OD (DOCTOR/OWNER)
(864) 232-2779
Entity
Organization
Contact information
Practice address
210 MILLS AVE, GREENVILLE, SC 29605-4020
(864) 232-2779
(864) 232-2779
Mailing address
210 MILLS AVE, GREENVILLE, SC 29605-4020
(864) 232-2779
(864) 232-2779
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
712
SC
332BX2000X
Oxygen Equipment & Supplies (DME)
714
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0643360001
DMEPOS
SC
01
—
410023165
RAIL ROAD MEDICARE
SC
01
—
CL3462
RAIL ROAD MEDICARE
SC
01
—
T24184
UPIN
SC
Enumeration date
12/07/2007
Last updated
10/06/2014
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